Marcus Mitchell Fuller, LAC , LMT, MACOM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

MED-ACU-LIC-70143 Issued in MT

Practice address

300 N Willson Ave Ste 2003
Bozeman, MT 59715-3597

Phone

(406) 577-2168

NPI assigned

Jan 9, 2019

Last updated

Jan 9, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ambulant Acupuncture LLC

  dba Ambulant Acupuncture

  • Acupuncturist
  • Bozeman, MT
  • NPI 1891314944
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1780157040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3205",
            "city": "VALDEZ",
            "state": "AK",
            "postal_code": "996863205",
            "telephone_number": "907-255-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N WILLSON AVE STE 2003",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597153597",
            "telephone_number": "406-577-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "MARCUS",
        "middle_name": "MITCHELL",
        "credential": "LAC , LMT,  MACOM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-09",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "AK",
            "license": "138929",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MT",
            "license": "MED-ACU-LIC-70143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Dee Frost, LCPC
• Nicole Frost, LCPC
• Daniel T. Kael Fry, MS, MFT
• Brian J Frykman, PAC
• Dell Arthur Fuller, MD
• Mackenzie Fulleton, LCSW
• Eugenia Foy Funk, PH.D.
• Donald C Funke, D.C.
• Karen Furu, LCPC
• Gabel PT Plus Wellness LLC

• Acupuncturist in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Acupuncturist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.